Obesity is the number one nutritional problem in the US. Because children bear the greatest lifetime health risk from overweight and obesity, interventions targeting them are of high priority. In response to RFA-HL- 10-004 "Childhood Obesity Prevention and Treatment Research Consortium", we propose the creation of the Minnesota Center for Pediatric Obesity Prevention, comprised of an interdisciplinary investigative team with extensive experience in community, school, primary care, and family pediatric obesity interventions. The goal of this Center is to translate a novel integration of primary care, home, and community-based intervention strategies developed in community settings into a comprehensive program that links intervention strategies across settings to promote sustained patterns of change in food intake, physical activity, and body weight among low income ethnically diverse children. This goal will be met through an iterative three phase series of research activities. In Phase 1, we will develop and pilot test a linked multi-setting intervention. Thirty children and their parents will be randomized to either usual care of the linked integrated intervention consisting of 1) messages from the primary care provider, with follow-up phone calls to assist with adoption of the behavioral and home environment messages;2) community parenting classes to help parents develop parenting behavioral skills around home environment management and behavioral shaping and reinforcement of their child's behaviors, including eating, physical activity and screen time;3) a community food and physical activity resource component to enhance neighborhood environmental opportunities and directly link families with neighborhood resources;and 4) a family advocate to coordinate primary care and parenting class recommendations and support the link to neighborhood food and physical activity resources via phone and home visits, in Phase II, we will conduct a 3-year randomized trial to evaluate the impact of the integrated, linked intervention on childhood obesity, diet, and physical activity among 500 3-5 year old children and their parents. In Phase III, we will conduct data analysis, engage in activities to promote sustainability of the intervention components, and disseminate research findings locally and nationally. RELEVANCE: The goal of the Minnesota Center for Pediatric Obesity Prevention is to translate a novel integration of primary care, home and community-based intervention strategies developed in community settings into a comprehensive program that links intervention strategies across settings to promote sustained patterns of change in food intake and physical activity to prevent obesity among at-risk low income, ethnically diverse preschool children.